Asthma‐predictive‐index, bronchial‐challenge, sputum eosinophils in acutely wheezing preschoolers

Ater, Dorit; Bar, Bat-El; Fireman, Nir; Fireman, Elizabeth; Shai, Hanita; Tasher, Diana; Dalal, Ilan; Mandelberg, Avigdor

doi:10.1002/ppul.22926

Cited by 13 publications

(18 citation statements)

References 23 publications

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“…A prospective study demonstrated that preschoolers who visited the ED owing to wheezing showed no difference in AHR from healthy pre schoolers. 32) This study has some limitations. First, because this was a crosssectional study, it was impossible to confirm whether the children developed asthma later.…”

Section: Discussionmentioning

confidence: 91%

Asthma predictive index as a useful diagnostic tool in preschool children: a cross-sectional study in Korea

et al. 2020

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Background: It is challenging to diagnose asthma in preschool children. The asthma predictive index (API) has been used to predict asthma and decide whether to initiate treatment in preschool children.Purpose: This study aimed to investigate the association between questionnaire-based current asthma with API, pulmonary function, airway hyperreactivity (AHR), fractional expiratory nitric oxide (FeNO), and atopic sensitization in preschool children.Methods: We performed a population-based cross-sectional study in 916 preschool children aged 4–6 years. We defined current asthma as the presence of both physician-diagnosed asthma and at least one wheezing episode within the previous 12 months using a modified International Study of Asthma and Allergies in Childhood questionnaire. Clinical and laboratory parameters were compared between groups according to the presence of current asthma.Results: The prevalence of current asthma was 3.9% in the study population. Children with current asthma showed a higher rate of positive bronchodilator response and loose and stringent API scores than children without current asthma. The stringent API was associated with current asthma with 72.2% sensitivity and 82.0% specificity. The diagnostic accuracy of the stringent API for current asthma was 0.771. However, no intergroup differences in spirometry results, methacholine provocation test results, FeNO level, or atopic sensitization rate were observed.Conclusion: The questionnaire-based diagnosis of current asthma is associated with API, but not with spirometry, AHR, FeNO, or atopic sensitization in preschool children.

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Section: Discussionmentioning

confidence: 91%

Asthma predictive index as a useful diagnostic tool in preschool children: a cross-sectional study in Korea

et al. 2020

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“…Ater et al have shown that wheezing preschoolers presenting to the emergency department, represent a unique population with a significantly higher rate of positive asthma predictive index and adenosine‐bronchial challenge tests compared to controls, and frequently express eosinophilic airway inflammation. They also showed that the MCH challenge was sensitive but much less specific than the adenosine challenge in these children . In our current study, we found that eight out of nine children who had severe respiratory exacerbations had severe BHR and we also showed the association between the severity of BHR to adenosine and the diagnosis of asthma 3 years later.…”

Section: Discussionmentioning

confidence: 99%

The correlation of adenosine challenge test results with subsequent clinical course among young children with suspected asthma: a retrospective cohort study

Rottensctreich

Picard

Avital

et al. 2019

Pediatric Pulmonology

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Aim: Our aim was to evaluate the correlation of Adenosine monophosphate challenge test (AMP-PCW) results with the patients' subsequent clinical course. Methods:We performed a 6-year retrospective cohort study of young children with suspected asthma who underwent AMP-PCW test.Results: Fifty four children were included in the study (median age, 50.5 months; range, 26-90). AMP-PCW was positive in 35 (65%) children. During the 3-year follow-up period, among 22 of 35 patients in the positive AMP-PCW group and among 17 of 19 in the negative AMP-PCW group-prophylactic therapy was not changed. Prophylactic therapy was initiated or its dose was escalated in 12 of 13 (92.3%) of the children with a positive AMP-PCW test compared to none of the children with a negative challenge test (P < 0.001). Prophylactic therapy was discontinued in only one (7.6%) of the children with a positive test as compared to two (100%) of the children with a negative test (P < 0.001).There were significantly fewer severe asthma exacerbations during a 3-year follow-up period after the challenge test as compared to the preceding 3-year period both in children with a positive (from 34 to 9 total events, P = 0.01) or a negative challenge test (from 16 to 0 events P = 0.01). The severity of airway hyper responsiveness was found to associate with the number of severe asthma exacerbations (P = 0.04) and with a diagnosis of asthma during the following 3 years (P = 0.02). Conclusions: AMP-PCW test results correlates with the subsequent clinical course of young children with suspected asthma performing the test. K E Y W O R D S adenosine, asthma, challenge test, hyper-responsiveness, wheezing

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“…14 Because the API has only been used in prospective or cross-sectional studies, [15][16][17][18][19] not a retrospective study, we recently validated use of the API for a retrospective study. The API and PAC showed a high concordance rate (82.9%), and the API showed excellent construct validity in association with known risk factors for asthma, such as other atopic conditions, a family history of asthma, and lower parental education, which indicates suitability of using the API for a retrospective study.…”

mentioning

confidence: 99%

Risk of herpes zoster in children with asthma

Wi¹,

Kim²,

Mehra³

et al. 2015

allergy asthma proc

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Asthma‐predictive‐index, bronchial‐challenge, sputum eosinophils in acutely wheezing preschoolers

Abstract: Wheezing preschoolers presenting to the ED is a unique population with significantly higher rate of positive S-API and adenosine-BCT compared with controls and frequently (50%) express eosinophilic airway inflammation.

Cited by 13 publications

References 23 publications

Asthma predictive index as a useful diagnostic tool in preschool children: a cross-sectional study in Korea

Asthma predictive index as a useful diagnostic tool in preschool children: a cross-sectional study in Korea

The correlation of adenosine challenge test results with subsequent clinical course among young children with suspected asthma: a retrospective cohort study

Risk of herpes zoster in children with asthma

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